Dr. Phil's diet

In a nutshell

Weight loss	Possible in the short term, less likely in the long term
Food Choices	Varied
In practice, this means	Difficult to follow. A lot of information to digest and behavioural changes to make.
Attention	Too severe on bread and alternative portions. Risk of caloric restriction too high for some individuals, especially men. Recommending natural products and supplements that are not effective for weight loss.

The origins

Phillip McGraw is the author of several best-selling books and the host of the American TV show Dr. Phil. His behavioural thinking and simplistic approach have made him one of the best known and most listened to psychologists in North America1. Following his many interventions with obese patients, Dr. Phil believes he has discovered the factors that provide the best results in treating this health problem. He therefore decided to share his knowledge with a wide audience. Its objective: to help people regain a healthy lifestyle in addition to a healthy weight.

The main principles

The objectives are

Definitive weight loss
Improving the quality of life
Decrease in morbidity caused by obesity

The main lines

Dr. Phil’s weight loss program has seven keys. It is based in part on the cognitive-behavioural approach, which aims to change habits without looking for the cause of undesirable behaviours.

First key: right thinking

First of all, it is important to be aware of your “own truth”. The weight loss process is much more difficult when you don’t believe in your ability to achieve your goals and you perceive yourself in a negative way. Dr. Phil therefore proposes to evaluate his “inner monologue”, to become aware of his erroneous thoughts and to confront them.

Second key: healing emotions

Some people turn to food when they feel strong emotions, whether it is happiness, sadness or stress. In order to avoid overeating and the resulting weight gain, it is necessary to manage these emotions. Dr. Phil calls it “emotional control”: learning to control your reactions to situations that provoke strong emotions. Then you have to find another way to relieve your tensions.

Third key: a winning environment

To put all the chances on his side, Dr. Phil strongly recommends that temptations be avoided, because they cannot be succumbed to when they are not within reach. So it’s about removing them from the grocery list… and avoiding restaurants where junk food is served.

Fourth key: control of cravings and impulses

When you have an overwhelming desire to eat, you may tend to rush to high-calorie foods. For those who want to lose weight, it is essential to manage these moments of crisis properly. The psychologist then suggests distracting oneself by being active: getting out of the house, moving, running, etc. Cravings pass out quite quickly when you don’t think about it.

Fifth key: a high-energy, high-efficiency power supply

According to Dr. Phil, some types of food require a significant amount of effort to prepare, chew and digest, to the point that it reduces their caloric impact. These foods therefore represent the basis of the diet model he recommends. It should be noted, however, that it does not encourage the banning of “pleasure” foods forever. The notion of portions is approached in a simplified way by using the distribution of food on the plate. This way, it is not necessary to weigh the food you eat.

Characteristics of energy-intensive foods1

They take time and require some effort to prepare.
They require a long chewing time and require a lot of energy to digest.
They cannot be swallowed quickly.
They do not fall into the ready-to-serve category.

Characteristics of low-energy foods1

They are practical, accessible and made to be swallowed quickly.
They encourage fast and uncontrolled feeding.
They require little or no preparation.
They do not require any chewing effort.
They melt in the mouth.
They can be easily consumed directly from their packaging or container.

Tables of preferred foods and foods to reduce or avoid

These tables are not exhaustive. For a more complete list, see reference 1.

Food groups	High energy expenditure Preferable
Starchy2 to 3 servingssa	Whole grain bread High-fibre breakfast cereals Cooked oatmeal Cooked whole grains (bulgur, brown rice, wild rice, quinoa, barley, or millet) Cooked pasta (whole wheat, kamut or spelt) Rye, multigrain or whole wheat crackers Homemade bran muffin Whole wheat pita roll Whole wheat or multigrain bagel Hot dog buns or spelt or whole wheat hamburger Whole wheat kaiser bread
Meat and Alternatives3 portionssb	Lean meat (veal, pork, lamb, beef) Seafood fishes Eggs Pulses Tofu, tempeh
Dairy products2 portionsc	Milk Yogurt Soy beverage Low-fat or fat-free iced milk
Fat1 portiond	Peanut, safflower, rapeseed, flax, sesame, sunflower, olive, vegetable and margarine oils without trans fat (1 tbsp) Nuts and seeds: almonds, peanuts, sunflower seeds, walnuts, Brazil nuts, pecans, pistachios Regular or low-calorie salad dressings
Fruits2 portionse	All fresh fruit and sugar-free fruit juices
Vegetables4 servings	All fresh vegetables
Others	Soft drinks and sweetened lemonades with sweeteners Meal substitutes (less than 240 calories per serving mixed with milk) Healthy bar (less than 140 calories per bar) Coffee, tea, herbal tea, soup broth

a) A portion of starchy foods corresponds to the size of a tennis ball or the volume corresponding to the cup-shaped hand.
b) A portion of meat and alternatives corresponds to the size of the palm of the hand.
c) A portion of dairy products corresponds to two tennis balls one above the other.
d) A portion of fat equals the size of one inch or two inches if the product is low-calorie.
e) A portion of fruit equals the size of a tennis ball.
f) A portion of vegetables equals the size of a tennis ball

Food groups	Low energy expenditure To be reduced or avoided
Starchy people	White flour bread (sliced bread, hamburger or hot dog bread, baguette, croissant, pita, bagel, etc.) Rusks and croutons with white flour Tortillas and white flour pizza crusts White pasta (spaghetti, macaroni, lasagna, etc.) Couscous Instant white rice or pre-cooked white rice Risotto Rice vermicelli Gnocchi Sweet cereals Cream of wheat Tapioca Pancakes Ascending White Flour English Muffin Waffles
Meat and Alternatives	Fatty meats Breaded fish, seafood and chicken Deli meats, sausages, bacon Fried eggs
Dairy products	Whole milk, whole yogurt, fat cheese, cream, ice cream, chocolate milk, dip
Fat content	Almonds, dry roasted or in oil, salted, flavoured, Nuts and unshelled seeds Butter, margarine, vegetable shortening
Fruits	Canned or frozen and sweetened fruit Sweetened fruit juices
Vegetables	Canned or frozen vegetables, in sauce Creamed corn Normandy-style potatoes, au gratin, mashed, fried, fried, fried, fried, chips Vegetables embedded in sauce or vinaigrette
Others	Beer, wine, spirits, soft drinks Frozen meals and fast food Doughnuts, cookies, buns, pies, cakes, muffins from the shops Apple butter, honey, maple syrup, candies, jams and sweet jellies, marshmallow, cheese sticks, pretzels, etc.

Sixth key: physical exercise

Dr. Phil says that physical activity is the key to not gaining back the pounds you lost. The activity chosen must be enjoyable enough to maintain motivation. In his view, any effort in this direction should be recognized and appreciated because it is an important step towards the main objective.

Seventh key: the circle of support

Dr. Phil recommends that you surround yourself with people who believe in your approach and who encourage you. This helps to strengthen motivation and to continue in the right direction. The choice of associates is important because some people, despite their good will, can be harmful. He also encourages those who follow his regime to report regularly on their progress to significant people.

Other recommendations from Dr. Phil

Take a multivitamin and mineral supplement, in addition to vitamin C (200 mg to 500 mg daily), vitamin E (100 IU to 200 IU daily) and calcium (500 mg to 1000 mg daily) supplements.
On his website, Dr. Phil sells energy bars, meal substitutes and other similar products, which he also recommends to help you lose weight.
When a person can no longer lose weight, he suggests that they get some supplements that he says are useful to “counter resistance to weight loss”.

Typical one-day menu

Morning meal

Half grapefruit, bran muffin, skim milk, coffee or tea

Snack: sugar-free yogurt and fresh fruit

Lunchtime meal

Salmon, lettuce and tomato salad, brown rice

Snack: fresh grapes

Evening meal

Chicken breast, broccoli, steamed yellow squash, small baked potato

The mechanisms of action

Alleged Alleged

According to Dr. Phil, integrating his seven keys into our lifestyle is, without a doubt, a guarantee of success for weight loss, but also to reduce the risk of diseases and disorders such as metabolic syndrome. It also increases self-esteem.

Dr. Phil argues that his seven keys do not require any will. Instead, he says, you have to organize your daily life and environment differently. Anyone can lose weight and maintain a healthy weight throughout their life through a healthy diet of high energy foods, physical exercise and recognition of their abilities and qualities.

Foods with a high energy expenditure allow you to reach satiation, in general, 20 minutes after the beginning of the meal. This avoids overeating. Many of the energy-intensive foods are high in fibre, which helps to fill hunger and stabilize blood sugar levels.

Obviously, this program requires a lot of motivation since the results are more progressive than those of draconian diets. Dr. Phil argues that the psychological process is the basis of the process. To start this new life, the individual must believe in his or her abilities and surround himself or herself well.

Demonstrated

The cognitive-behavioural approach at the heart of Dr. Phil’s weight loss program has been the subject of a large number of studies. It has proven its effectiveness in the short term, but unfortunately not in the long term. Studies indicate that almost all those who adopted this approach regained their lost weight after five years2-3.

Moreover, the theories to which Dr. Phil adheres are not unanimously accepted by the scientific community. Although he does not write it in these specific terms, some of his recommendations aim to stabilize blood sugar levels by limiting foods with high glycemic indexes (high in calories and carbohydrates). However, the results of studies on glycemic index and weight loss are sometimes contradictory. A prospective study of men and women concluded that a diet with a high glycemic index may lead to an increase in body weight, fat percentage and waist circumference, particularly in sedentary women. But this study also suggests that physical activity may protect against weight gain induced by a high glycemic index diet4. In another study, which lasted ten weeks, the authors found no significant difference in weight and fat percentage between the low glycemic index diet and the high glycemic index diet. However, the first diet caused a 10% decrease in LDL cholesterol (“bad cholesterol”)5.

Dr. Phil recommends taking vitamin C and E supplements. However, the effectiveness of these supplements is uncertain in preventing or treating several diseases6-9.

Dr. Phil contradicts himself when he says that “the will is useless” to succeed in his program. Indeed, he also states that motivation is necessary. Aren’t will and motivation of the same order?

Several elements of this method – re-evaluation of self-judgment, emotion management, physical activity – are likely to reinforce motivation and thus help in a healthy approach.

Advantages and disadvantages

Satiety and well-being

The foods offered by Dr. Phil ensure satiety: whole grain cereal products, fruits and vegetables, legumes, lean meats, dairy products. But it is important not to stick to the only three servings of grain products he recommends. By comparison, Canada’s Food Guide recommends a minimum of five servings. Eating insufficient amounts of grain products can lead a person to compensate with an excess of carbohydrate-rich foods.

In practice, this means

Dr. Phil’s weight loss method can be easily applied in everyday life, at home, at work or in a restaurant. His book explains in detail each of the seven keys of the program. It also provides an exhaustive list of high and low energy consuming foods.

The most complex part of this method is the psychological aspect. The person who wishes to join this program must undergo a whole process of behavioural change before reaching his or her weight loss goal. Many insights and reflections are needed to truly embrace the seven keys to success.

Weight loss

The method proposed by Dr. Phil can lead to weight loss. However, this method has not been studied in either the short or long term. It cannot therefore be concluded that it is effective.

Attention

The restriction is severe for grain products.
As for the supplements he recommends to help lose weight, they are not supported by any scientific reference demonstrating their effectiveness beyond any doubt.
Dr. Phil’s diet is a “one size fits all” diet: it does not take into account the genetic differences between individuals, which require adequate nutritional requirements.